Emergence of extensively drug-resistant Klebsiella pneumoniae from broiler chickens and clinical samples in Egypt.

BACKGROUND

Klebsiella pneumoniae (K. pneumoniae) is an opportunistic pathogen belonging to Enterobacteriaceae family. It is present in the intestinal tract of animals and humans, and is considered as a major threat to public health. A total of 33 previously identified K. pneumoniae strains isolated from of broiler chicken (n = 20) and, humans (n = 13) were tested for their antimicrobial sensitivity and virulence genes detection.

RESULTS

The antimicrobial sensitivity testing of broiler chickens K. pneumoniae strains, showed complete phenotypic resistance towards ampicillin (100%), colistin (100%), fosfomycin (100%), trimethoprim/sulphamethaxole (100%) followed by gentamicin (90%), cefotaxime (90%) and chloramphenicol (75%). However, all the isolates were sensitive to imipenem (100%). K. pneumoniae human strains showed complete phenotypic resistance to fosfomycin (100%), followed by ampicillin (92.3%), colistin (92.3%), and ciprofloxacin and trimethoprim/sulfamethaxole (76.9%, each). The resistance gene profiling of the chicken strains was cmlA (65%), dfrA1 (65%), mcr1 (60%), tetA (50%), fosA (40%), and sul1 (35%), and the most prevalent virulence gene was rmpA (85%), that was detected either alone in 9 isolates (52.9%), or in combination with the magA gene in 8 isolates (47.1%), and with fimH gene in 8 isolates (47.1%), followed by fimH (55%) and magA genes (40%). On the other hand, the human strains gene profiling showed mcr1 (61.5%), cmlA (53.8%), and sul1 (46.2%) genes, while dfrA1 was not detected. The most prevalent virulence genes in the human strains were rmpA and magA genes (46.2%, each), followed by fimH gene (38.5%). Overall, multidrug-resistant (MDR) (33.3%), extensively-drug resistant (XDR) (57.6%) and pan-drug resistant (PDR) (9.1%) isolates were detected.

CONCLUSION

The distribution of such virulent and resistant K. pneumoniae isolates among apparently healthy broiler chicken, highlights their potential role in the transmission of both resistance and virulence attributes to the surrounding environment and human contacts. Moreover, spreading of carbabenem resistant K. pneumoniae among human isolates, suggest the urgent need for more strict measures for the uncontrolled usage of antibiotics.